| NPI | 1982794061 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: CA G46596) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: NM 83-71) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2022-11-22 |